Judge to rule on Bryant, BlueCross

JACKSON – U.S. District Judge Henry Wingate will rule Monday on whether Gov. Phil Bryant’s intervention against BlueCross & BlueShield in its ongoing battle with a major hospital company in the state will stand.

BRYANT

In a three-hour hearing Friday, attorneys for Insurance Commissioner Mike Chaney and BlueCross argued that Bryant assumed powers he did not have by issuing an executive order forcing the insurer to reinstate to its network 10 privately owned hospitals across the state owned by Health Management Associates, including Gilmore Memorial in Amory.

Harold Pizzetta, an assistant attorney general and one of the office’s primary litigators, contended whether Bryant had the authority should be decided by a state court as opposed to a federal court. But Pizzetta said it is clear under the state Constitution that Bryant had the authority to issue an executive order if he found evidence that access to health care was compromised.

The issue is pitting two statewide Republican elected officials – the governor and insurance commissioner – against each other while Democratic Attorney General Jim Hood is defending Bryant.

John Corlew, a Jackson attorney representing Chaney, argued vigorously that “the governor has stepped off the reservation to do something he knows nothing about” in an area where he has no authority.

Bryant’s executive order issued earlier this week is slated to take effect on Tuesday.

The dispute arose when BlueCross dropped 10 hospitals owned by Florida-based HMA from its network in September in the midst of a disagreement over how much the hospitals should be reimbursed by the state’s biggest provider of health insurance.

BlueCross this week announced it was restoring four HMA hospitals to its network, including Gilmore Memorial in Amory.

Bryant’s order would restore the hospitals to the health insurance network for 60 days while ordering Chaney to review the issue to see if any state laws were being broken – specifically a statute requiring insurance companies to provide reasonable access to health care for customers in their network.

Pizzetta said the state Constitution makes the governor “the chief executive officer” with the authority to become involved in any area of state law that he does not believe is being enforced.

Wingate repeatedly peppered Pizzetta with questions about what research did Bryant conduct to determine that access to health care for BlueCross customers might be jeopardized by the dispute between the two corporations. Pizzetta answered that if there was “a rational” expectation that access was hindered that the governor could act.

David Kaufman, a Jackson attorney representing BlueCross, said Chaney already stated before a legislative hearing that he found no reason under state law for him to intervene in the dispute, but his office was conducting a further investigation that was started before Bryant’s executive order.

Kaufman said patients had other health care options and that HMA already had said that BlueCross customers who received care in their facilities would not incur additional out-of-pocket expenses because they would be charged lower rates.

Kaufman said HMA was being reimbursed at the same rate as other Mississippi hospitals, but wanted a higher rate. He said HMA and BlueCross were “sophisticated companies” that had entered into a contract that provided nullification clauses for both parties. He said Bryant was trying to trump the contractual agreement.

After the hearing in a prepared statement, J. Allen Tyra, Gilmore Memorial chief executive officer, said, “We will continue attempting to work with BlueCross to resolve this matter as quickly as possible for the benefit of all of the patients, doctors and communities involved. Patients should know that regardless of the events of the next few days, we are going to continue to treat all Blue Cross policy holders as in-network.’’